Cleft Lip ; surgery ; Cleft Palate ; surgery ; Humans ; Maxillofacial Development ; physiology

The Department of Plastic Surgery of the Yonsei University College of Medicine in Korea studied 2422 cases of cleft lip and cleft palate patients for 20 years An analysis of the date resulted in the following: 1) of the 33,130 live births in our hospital in 20 years (Jan. 1962-Dec. 1981), 44 of the birth certificates specified cleft lip or palate. This is a ratio of 1.33 cases per 1000 live births. 2) The ratios for left to right to bilateral cleft was 3.4:1.9:1.0. Higher percentage of males than females had cleft lip-palate combined, than cleft lip only. A higher percentage of females had cleft palate only. 3) A positive family history was noted in 151 out of 2422 cases; (6.3%). 4) 45% of the patients had an associated congenital malforation of which heart anomaly was the most common. 5) Lip closure was scheduled to be done within 3 months of age; palate closure was scheduled between 12 to 18 months. 6) The triangular flap method was used for the lip repair. The palate was repaired by the KilnerWardill method in all cases. The operative results were satisfactory m both lip controur and speech. Noting the lack of published reports about this topic, especially among the oricental population, we believe this paper will serve to enhance the knowledge of the field of cleft lip and cleft palate patients in Asia.
Cleft Lip/epidemiology* ; Cleft Lip/genetics ; Cleft Lip/surgery ; Cleft Palate/epidemiology* ; Cleft Palate/genetics ; Cleft Palate/surgery ; Female ; Human ; Infant ; Infant, Newborn ; Korea ; Male

No abstract available.
Cleft Lip ; Humans ; Orthognathic Surgery ; Palate

Bilateral cleft lip shows various clinical characteristics and the typical bilateral complete cleft lip usually features prominent premaxilla, short columella, non-protruded nasal tip, flared alar base and asymmetrical alar cartilage. The prolabium is usually short and demonstrate total absence of oricularis oris muscle. Therefore a satisfactory reconstruction of the lip in both the functional and cosmetic aspect is very difficult, especially in philtral column, columella, and nasal portion. Various techniques of cleft lip repair are being developed. The staged repair of bilateral cleft lip, one side and then the other, has been superseded by simultaneous/symmetrical repair of both sides that also included complete muscular closure. And by Mulliken1 and Cutting2,3, simultaneous/symmetrical repair also has been changed to one stage repair of bilateral complete cleft lip together with nasal deformity correction. The authors performed one stage closure by means of Noordhoff method without presurgical orthopedics, which provided simultaneous/symmetrical repair including complete muscular closure and at the same time reproduced the tubercle and Cupid's bow by using both lateral lip segment. There were some problems after surgical repair. First, short or absent columella were inevitably present which could be corrected by columellar lengthening. Secondly in complete cleft lip without cleft palate, there is persistent protruding of the premaxilla and finally resultant scar widening of the cupid's bow and philtral column, which could be corrected by orthognathic surgery. But these procedures are only secondary solutions for correction of already-made deformity. We demonstrated problems and their solutions in the performance of the Noordhoff method and introduced Cutting's presurgical nasoalveolar molding as a fundamental solution2,3.
Cartilage ; Cicatrix ; Cleft Lip* ; Cleft Palate ; Congenital Abnormalities ; Fungi ; Lip ; Orthognathic Surgery ; Orthopedics

OBJECTIVETo Verify the safety and reliability of one-stage repair of complete cleft Lip and palate in infancy and to obtain the primary result.

METHODSThe simultaneous repair of complete cleft Lip and palate in infants 3 to 12 months of age were performed in 271 cases. The deformities include 185 cases of typical complete unilateral clefts and 75 cases of complete bilateral clefts, and other 11 atypical cleft infants. The preoperative orthopedic treatment for wide alveolar cleft was undertaken in 24 infants and the lip appearance and speech outcome were evaluated in 116 children by 1 to 4 years' postoperative follow-up.

RESULTSAll infants, except for dyspnea in 2 babies, palatal fistula formation in 6 cases and temporary wound hemorrhage in 5 infants, were recovered without complications. After orthopedic treatment, the width of the alveolar cleft was reduced 6.1 mm in average. The evaluation showed that 93.1% of children had got good or excellent lip appearance. And the acceptable or excellent speech was found in 94.8% children.

CONCLUSIONSSimultaneous repair of complete cleft lip and palate in infancy is safety and reliable. The preoperative orthopedic procedure is able to reduce the wide alveolar cleft and to achieve alignment of alveolar segments. The acceptable and or excellent lip appearance and speech function could be obtained in this one-stage operative procedure in infants.

OBJECTIVEThis study aimed to observe the postoperative pain rate and degree of pain in preschool children with cleft lip and palate, and investigate the effect of nursing intervention on pain relief.

METHODSA total of 120 hospitalized cases of three- to seven-year-old preschool children with cleft lip and palate were selected from May to October 2011. The subjects were randomly divided into the control group and experimental groups 1, 2, and 3. The control group used conventional nursing methods, experimental group 1 used analgesic drug treatment, experimental group 2 used psychological nursing interventions, and experimental group 3 used both psychological nursing intervention and analgesic drug treatment. After 6, 12, 24, and 48 h, pain self-assessment, pain parent-assessment, and pain nurse-assessment were calculated for the four groups using the pain assessment forms, and their ratings were compared.

RESULTSThe postoperative pain rates of the four groups ranged from 50.0% to 73.3%. The difference among the four groups was statistically significant (P < 0.001). The differences among the control group and experimental groups 1 and 2 were not statistically significant (P = 0.871), whereas the differences among experimental group 3 and the other groups were statistically significant (P < 0.001).

CONCLUSIONPostoperative pain in preschool children with cleft lip and palate is common. Psychological nursing intervention with analgesic treatment is effective in relieving postoperative pain.

Cleft lip and/or palate (CLP) are the most common craniofacial malformations in humans. Speech problems often persist even after cleft repair, such that follow-up articulation training is usually required. However, the neural mechanism behind effective articulation training remains largely unknown. We used fMRI to investigate the differences in brain activation, functional connectivity, and effective connectivity across CLP patients with and without articulation training and matched normal participants. We found that training promoted task-related brain activation among the articulation-related brain networks, as well as the global attributes and nodal efficiency in the functional-connectivity-based graph of the network. Our results reveal the neural correlates of effective articulation training in CLP patients, and this could contribute to the future improvement of the post-repair articulation training program.
Brain/diagnostic imaging* ; Cleft Lip/surgery* ; Cleft Palate/surgery* ; Humans ; Magnetic Resonance Imaging ; Reading

OBJECTIVES: To study the effect of preoperative prophylactic use of antibiotics on wound infection in patients with cleft lip. METHODS: Aretrospective study was conducted on the clinical data of 1 361 patients who underwent one-stage cleft lip repair in the Department of Cleft Lip and Palate in West China Hospital of Stomatology, Sichuan University, from January 2015 to November 2018. The patients were divided into two groups according to whether prophylactic antibiotics were used or not. There were 594 patients in the prevention group, including 373 unilateral incomplete cleft lip (UICL) patients, 157 unilateral complete cleft lip (UCCL) patients, 25 bilateral incomplete cleft lip (BICL) patients, 39 bilateral complete cleft lip (BCCL) patients. There were 767 patients in the non-prophylactic group, including 482 UICL patients, 211 UCCL patients, 31 BICL patients, 43 BCCL patients. The relationship between preoperative and postoperative leukocyte count, preoperative and postoperative body temperature, and postoperative wound infection were compared between the two groups. RESULTS: No significant difference was observed in the leukocyte count and body temperature between both groups ( CONCLUSIONS The preoperative prophylactic use of antibiotics has no significant effect on the incidence of postoperative infection in patients undergoing cleft lip repair.
Anti-Bacterial Agents ; Cleft Lip/surgery* ; Cleft Palate/surgery* ; Humans ; Infant ; Surgical Wound Infection/prevention & control*

OBJECTIVE: To analyze the risk factors of preoperative upper respiratory infections in children with cleft lips and palate (CLP) and investigate preventive measures to reduce infections and improve the quality of treatments. METHODS: A total of 510 children with CLP of ages 3 years old or younger were selected from hospital cases from June to December 2017. The test group comprised 50 children with upper respiratory infections, whereas the control group comprised 460 children without upper respiratory infections. A t-test and a multivariate logistic analysis were utilized to analyze the risk factors and to investigate the preventive measures. RESULTS: Feeding patterns, the presence of infected companions during hospitalization, and ventilation at night were statistically significant. The feeding patterns and the presence of infected companions during hospitalization were independent risk factors for upper respiratory infections in children with CLP. CONCLUSIONS Bottle feeding, infected companions during hospitalization, and the absence of window ventilation at night are risk factors for preoperative upper respiratory infections in children 3 years old or younger with CLP. Among the risk factors identified, feeding patterns and the presence of infected companion during hospitalization were the most influential. Medical staff members should streng-then corresponding health education and nursing measures to control the risk factors.
Child ; Child, Preschool ; Cleft Lip ; surgery ; Cleft Palate ; surgery ; Cross Infection ; prevention & control ; Humans ; Risk Factors

The maxillofacial region has multiple functions such as breathing, language, and facial expressions. Children's maxillofacial development is a complex and long process, which is affected by many factors such as genetics, diseases, bad habits and trauma. Early detection, early diagnosis, and early treatment are important concepts in children's maxillofacial management. Digital technology medicine is an emerging technology based on medical imaging and anatomy that has emerged in recent years. The application of this technology in the field of clinical medicine will undoubtedly bring great benefits to children's maxillofacial management. This article summarizes the research on digital technology in children's maxillofacial management, and focuses on the research on children's malocclusion, children's OSA, cleft lip and palate and other related diseases.
Humans ; Child ; Cleft Lip/surgery* ; Cleft Palate/surgery* ; Digital Technology ; Respiration